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Pulmonology . Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review

tetano

Editor, Senior Moderator
Pulmonology


. 2020 Jul 20;S2531-0437(20)30153-7.
doi: 10.1016/j.pulmoe.2020.07.003. Online ahead of print.
Rationale and evidence on the use of tocilizumab in COVID-19: a systematic review


A Cortegiani[SUP] 1 [/SUP], M Ippolito[SUP] 2 [/SUP], M Greco[SUP] 3 [/SUP], V Granone[SUP] 4 [/SUP], A Protti[SUP] 5 [/SUP], C Gregoretti[SUP] 6 [/SUP], A Giarratano[SUP] 7 [/SUP], S Einav[SUP] 8 [/SUP], M Cecconi[SUP] 9 [/SUP]



Affiliations

Abstract

Background: Tocilizumab is an IL-6 receptor-blocking agent proposed for the treatment of severe COVID-19. The aim of this systematic review was to describe the rationale for the use of tocilizumab for the treatment of COVID-19 and to summarize the available evidence regarding its efficacy and safety.
Methods: MEDLINE, PubMed, EMBASE, pre-print repositories (bioRxiv and medRxiv) and two trial Registries were searched for studies on the use of tocilizumab in COVID-19 or SARS-CoV-2 infection, viral pneumonia, and/or sepsis until 20th June 2020.
Results: We identified 3 indirect pre-clinical studies and 28 clinical studies including 5776 patients with COVID-19 (13 with a comparison group, 15 single-arm). To date, no randomized trials have been published. We retrieved no studies at low risk of bias. Forty-five ongoing studies were retrieved from trial registries.
Conclusions: There is insufficient evidence regarding the clinical efficacy and safety of tocilizumab in patients with COVID-19. Its use should be considered experimental, requiring ethical approval and clinical trial oversight.

Keywords: COVID-19; Coronavirus; Pneumonia; SARS-CoV-2; Tocilizumab.
 
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